- Book学术

发布求助

文献互助智能选刊最新文献

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2024-11-29 DOI:10.1016/j.sleep.2024.11.038

Shrijan Bariya, Yun Tao, Ruiqing Zhang, Ming Zhang

{"title":"Impact of sleep characteristics on IVF/ICSI outcomes: A prospective cohort study.","authors":"Shrijan Bariya, Yun Tao, Ruiqing Zhang, Ming Zhang","doi":"10.1016/j.sleep.2024.11.038","DOIUrl":null,"url":null,"abstract":"Background: Infertility affects millions of individuals worldwide, imposing significant personal and societal burdens. Assisted reproductive technologies (ART), such as IVF and ICSI, provide hope for many, yet clinical pregnancy rate per embryo transfer remains around 35 %. Modifiable lifestyle factors, including sleep, may influence ART outcomes. However, the relationship between specific sleep characteristics and IVF/ICSI success is unclear. This study aims to explore the associations between sleep characteristics and various IVF/ICSI outcomes. Additionally, we investigated if perceived stress mediates these relationships.Methods: This prospective cohort study enrolled 174 women undergoing IVF/ICSI at Zhongnan Hospital of Wuhan University from December 2021 to December 2023. Prior to initial ART treatment, participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS-10). IVF/ICSI outcomes such as the number of retrieved oocytes, matured oocytes, number of fertilized oocytes, fertilization rate, good-quality embryos, blastocyst formation rate and early pregnancy outcome (implantation and clinical pregnancy) were obtained from medical records. We employed multivariate generalized linear models to assess the associations between sleep characteristics and IVF/ICSI outcomes. Dose-response relationships between napping duration and maturation rate were analyzed using generalized additive models. Mediation analysis was used to assess the role of stress in the relationship between sleep characteristics and IVF/ICSI outcomes.Results: Women reporting poor sleep quality had significantly fewer retrieved oocytes (-22.89 %, 95%CI: 37.82 %, -4.00 %) and matured oocytes (-22.01 %, 95%CI: 37.54 %, -2.62 %). Those sleeping ≥10 h per night had fewer retrieved oocytes (-30.68 %, 95%CI: 48.88 %, -6.00 %), matured oocytes (-27.17 %, 95%CI: 46.57 %, -0.73 %), and good-quality embryos (-45.64 %, 95%CI: 65.43 %, -14.51 %). Women experiencing difficulty falling asleep more than three times a week had a significant reduction in blastocyst rates (-64.40 %, 95 % CI: 85.55 %, -12.30 %). Those reporting difficulty falling asleep less than once a week had fewer retrieved oocytes (-28.89 %, 95%CI: 47.34 %, -3.98 %), and matured oocytes (-27.77 %, 95%CI: 46.90 %, -1.73 %). Napping exceeding 1 h daily was associated with a significantly lower oocyte maturation rate (-73.8 %, 95%CI: 88.91 %, -38.06 %). A significant non-linear dose-response relationship was observed between napping duration and maturation rate (p < 0.001), with maturation rates initially increasing slightly with short naps but declining significantly with longer naps, particularly beyond 1 h. This relationship was significant among women with good sleep quality (PSQI ≤5) (p < 0.001) and those with normal BMI (p = 0.0005). Perceived stress did not significantly mediate these associations.Conclusion: Our findings suggest that sleep characteristics, particularly poor quality, difficulty falling asleep, long sleep durations, negatively impact various IVF/ICSI outcomes. Longer daytime napping is inversely associated with oocyte maturation rates, especially among women with good sleep quality and normal BMI. Perceived stress did not appear to influence the relationship between sleep and IVF outcome. While optimizing sleep patterns may hold promise for improving IVF/ICSI success rates, it is essential to approach lifestyle guidance with caution, given the current limitations in confirming causative roles. Further studies are needed to clarify the extent and nature of the relationship between sleep characteristics and IVF/ICSI outcomes.","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"122-135"},"PeriodicalIF":3.8000,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.sleep.2024.11.038","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：不孕症影响着全球数百万人，给个人和社会带来了沉重负担。试管婴儿和卵胞浆内单精子显微注射等辅助生殖技术（ART）为许多人带来了希望，但每次胚胎移植的临床妊娠率仍在 35% 左右。可改变的生活方式因素（包括睡眠）可能会影响 ART 的结果。然而，特定睡眠特征与试管婴儿/卵胞浆内单精子显微注射（IVF/ICSI）成功率之间的关系尚不清楚。本研究旨在探讨睡眠特征与各种 IVF/ICSI 结果之间的关系。此外，我们还调查了感知到的压力是否会调节这些关系：这项前瞻性队列研究在 2021 年 12 月至 2023 年 12 月期间招募了 174 名在武汉大学中南医院接受 IVF/ICSI 的女性。在初次 ART 治疗前，参与者完成了匹兹堡睡眠质量指数（PSQI）和感知压力量表（PSS-10）。IVF/ICSI的结果，如取回的卵母细胞数、成熟卵母细胞数、受精卵数、受精率、优质胚胎、囊胚形成率和早孕结果（着床和临床妊娠）均来自医疗记录。我们采用多变量广义线性模型来评估睡眠特征与 IVF/ICSI 结果之间的关联。使用广义加法模型分析了午睡时间与成熟率之间的剂量-反应关系。利用中介分析评估了压力在睡眠特征与IVF/ICSI结果之间关系中的作用：结果：睡眠质量差的妇女取回的卵母细胞（-22.89 %，95%CI：37.82 %，-4.00 %）和成熟的卵母细胞（-22.01 %，95%CI：37.54 %，-2.62 %）明显较少。每晚睡眠时间≥10 小时的女性，其取回的卵母细胞（-30.68 %，95%CI：48.88 %，-6.00 %）、成熟卵母细胞（-27.17 %，95%CI：46.57 %，-0.73 %）和优质胚胎（-45.64 %，95%CI：65.43 %，-14.51 %）均较少。每周入睡困难超过三次的妇女的囊胚率显著下降（-64.40 %，95 % CI：85.55 %，-12.30 %）。每周入睡困难次数少于一次者，取卵率（-28.89 %，95%CI：47.34 %，-3.98 %）和成熟卵母细胞率（-27.77 %，95%CI：46.90 %，-1.73 %）均较低。每天午睡超过 1 小时，卵母细胞成熟率明显降低（-73.8 %，95%CI：88.91 %，-38.06 %）。午睡时间与卵母细胞成熟率之间存在明显的非线性剂量反应关系（p 结论：午睡时间与卵母细胞成熟率之间存在明显的非线性剂量反应关系：我们的研究结果表明，睡眠特征，尤其是睡眠质量差、入睡困难、睡眠持续时间长，会对试管婴儿/卵胞浆内单精子显微注射的各种结果产生负面影响。白天小睡时间较长与卵母细胞成熟率成反比，尤其是在睡眠质量好、体重指数正常的女性中。感知到的压力似乎并不影响睡眠与试管婴儿结果之间的关系。虽然优化睡眠模式可能有望提高试管婴儿/卵胞浆内单精子显微注射（IVF/ICSI）的成功率，但鉴于目前在确认因果关系方面的局限性，必须谨慎对待生活方式指导。还需要进一步的研究来明确睡眠特征与 IVF/ICSI 结果之间关系的程度和性质。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Impact of sleep characteristics on IVF/ICSI outcomes: A prospective cohort study.

Background: Infertility affects millions of individuals worldwide, imposing significant personal and societal burdens. Assisted reproductive technologies (ART), such as IVF and ICSI, provide hope for many, yet clinical pregnancy rate per embryo transfer remains around 35 %. Modifiable lifestyle factors, including sleep, may influence ART outcomes. However, the relationship between specific sleep characteristics and IVF/ICSI success is unclear. This study aims to explore the associations between sleep characteristics and various IVF/ICSI outcomes. Additionally, we investigated if perceived stress mediates these relationships.

Methods: This prospective cohort study enrolled 174 women undergoing IVF/ICSI at Zhongnan Hospital of Wuhan University from December 2021 to December 2023. Prior to initial ART treatment, participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS-10). IVF/ICSI outcomes such as the number of retrieved oocytes, matured oocytes, number of fertilized oocytes, fertilization rate, good-quality embryos, blastocyst formation rate and early pregnancy outcome (implantation and clinical pregnancy) were obtained from medical records. We employed multivariate generalized linear models to assess the associations between sleep characteristics and IVF/ICSI outcomes. Dose-response relationships between napping duration and maturation rate were analyzed using generalized additive models. Mediation analysis was used to assess the role of stress in the relationship between sleep characteristics and IVF/ICSI outcomes.

Results: Women reporting poor sleep quality had significantly fewer retrieved oocytes (-22.89 %, 95%CI: 37.82 %, -4.00 %) and matured oocytes (-22.01 %, 95%CI: 37.54 %, -2.62 %). Those sleeping ≥10 h per night had fewer retrieved oocytes (-30.68 %, 95%CI: 48.88 %, -6.00 %), matured oocytes (-27.17 %, 95%CI: 46.57 %, -0.73 %), and good-quality embryos (-45.64 %, 95%CI: 65.43 %, -14.51 %). Women experiencing difficulty falling asleep more than three times a week had a significant reduction in blastocyst rates (-64.40 %, 95 % CI: 85.55 %, -12.30 %). Those reporting difficulty falling asleep less than once a week had fewer retrieved oocytes (-28.89 %, 95%CI: 47.34 %, -3.98 %), and matured oocytes (-27.77 %, 95%CI: 46.90 %, -1.73 %). Napping exceeding 1 h daily was associated with a significantly lower oocyte maturation rate (-73.8 %, 95%CI: 88.91 %, -38.06 %). A significant non-linear dose-response relationship was observed between napping duration and maturation rate (p < 0.001), with maturation rates initially increasing slightly with short naps but declining significantly with longer naps, particularly beyond 1 h. This relationship was significant among women with good sleep quality (PSQI ≤5) (p < 0.001) and those with normal BMI (p = 0.0005). Perceived stress did not significantly mediate these associations.

Conclusion: Our findings suggest that sleep characteristics, particularly poor quality, difficulty falling asleep, long sleep durations, negatively impact various IVF/ICSI outcomes. Longer daytime napping is inversely associated with oocyte maturation rates, especially among women with good sleep quality and normal BMI. Perceived stress did not appear to influence the relationship between sleep and IVF outcome. While optimizing sleep patterns may hold promise for improving IVF/ICSI success rates, it is essential to approach lifestyle guidance with caution, given the current limitations in confirming causative roles. Further studies are needed to clarify the extent and nature of the relationship between sleep characteristics and IVF/ICSI outcomes.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.